LV Times columnist: Mental health can't be overlooked as factor in state crime

Friday

Aug 29, 2014 at 12:47 PM

By ERNEST EVANSLeavenworth Times columnist

Leavenworth County’s distinguished state senator, Steve Fitzgerald, wrote an insightful letter to the editor about my column a few weeks ago concerning the problem of crime in Kansas.Specifically, he correctly noted that inadequate attention to the mental health issue is aggravating crime problems of Kansas.In understanding the connection between these issues you have to go back to a major development in U.S. mental health policy: The “deinstitutionalization” movement of the 1960s.With the development of effective antipsychotic medications in the 1950s, people began to argue that, instead of spending their whole lives in psychiatric hospitals, most of the nation’s seriously mentally ill patients could be released from hospitals and instead be treated at outpatient community mental health centers. The idea soon got wide acceptance: In 1955, there were 560,000 people in long-term psychiatric hospitals; by 1980, the figure was down to 130,000.However, in all-too-many cases the planned community mental health centers were never funded or were not adequately funded. So, mentally ill people were discharged with nowhere to go. And, as the number of patients in hospitals declined, a lot of these hospitals were closed, so mentally ill individuals could not return to the places they had formerly resided in.This mishandling of the well-intentioned deinstitutionalization program has three consequences for crime.First, many of the discharged mental patients cannot function properly in society on their own so they end up committing crimes out of a lack of having even the most basic social skills. We saw a tragic case of that just recently in Ottawa, where a young boy who had just hours before been discharged from a psychiatric hospital made what were seen as threatening gestures toward several police officers and the officers shot and killed him out of concern for their safety.Second, once these mentally ill individuals have committed crimes they are often sent to prison. The nation’s prison facilities provide woefully inadequate treatment for incarcerated mentally ill inmates, so these individuals’ illnesses usually get worse while they are in prison, and that fact makes them more likely to commit violent crimes either while in prison or when they are released.Third, and particularly tragic in its consequences, is the decline in the number of available psychiatric beds in hospitals and in mental health funding in general, making it harder to find available space for people who really do need to be hospitalized.Last May in Kansas City, Mo., we witnessed a tragic “suicide by cop” of an Iraq War veteran, Issac Sims. Sims' family had desperately tried to get him help for his severe post-traumatic stress disorder, but there was a long waiting list at Veterans Affairs, and state hospitals had no room for him.In despair, he went out on the streets and threatened police officers with a gun and was shot and killed.We live in a time of tight budgets at all levels of government, so I fully understand a lot of people will respond to this column by saying, “Well, this sounds like a serious problem, but we simply do not have the funds to deal with it right now.”However, a number of evaluations of this issue have concluded that by investing more money in making deinstitutionalization work properly society can actually save money in the long run.Arresting, trying and incarcerating people is a most expensive proposition — it would be much more compassionate, and quite possibly a lot cheaper, to provide more funding for community mental health centers and thereby drastically reduce the likelihood mentally ill individuals will run afoul of the justice system.

Dr. Ernest Evans is a political science professor at Kansas City Kansas Community College-Leavenworth Center and a regular guest lecturer at the Command and General Staff College at Fort Leavenworth. He is a Leavenworth resident.

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